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首页> 外文期刊>Circulation journal >Prognostic Value of Plasma B-Type Natriuretic Peptide in the Long-Term Follow-up of Patients With Transposition of the Great Arteries With Morphologic Right Systemic Ventricle After Atrial Switch Operation
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Prognostic Value of Plasma B-Type Natriuretic Peptide in the Long-Term Follow-up of Patients With Transposition of the Great Arteries With Morphologic Right Systemic Ventricle After Atrial Switch Operation

机译：血浆B型利钠肽在房室切换手术后对形态右系统室大动脉移位患者的长期随访中的预后价值

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Background: B-type natriuretic peptide (BNP) is an established marker for heart failure assessment, but the prognostic quality of BNP after atrial switch operation (ASO) has not yet been elucidated. Methods?and?Results: In 89 patients (median age, 24 years; range, 15–35 years) after ASO, BNP was measured. During a 48-months follow-up we focused on critical cardiac events, defined as decompensation, sudden cardiac death or need for heart transplantation. BNP was considerably lower in 81 patients in functional class (FC) I/II (median, 35 pg/ml; range, 3–586 pg/ml) than in 6 patients in FC III/IV (median, 246 pg/ml; range, 14–1,150 pg/ml, P≤0.073). BNP was significantly higher after Mustard than after Senning procedure (P≤0.030). There was no significant difference in BNP between simple or complex transposition of the great arteries (TGA) (P≤0.44). Eleven subjects (13%, 95% CI: 7–22%) had a critical cardiac event within 48 months. On ROC analysis BNP had a high predictive value regarding discrimination of patients with and without critical events (area under the ROC curve, 0.90; 95% CI: 0.76 to >0.99, P<0.001). The cut-off was 85 pg/ml (sensitivity, 88%; specificity, 85%). Additionally, estimated event-free-survival was longer after Senning than after Mustard procedure (P≤0.017). There was no significant difference in outcome between patients with simple or complex TGA with regard to occurrence of critical events. Conclusions: BNP is a sensitive and specific prognostic marker for critical cardiac events after ASO. ( Circ J 2015; 79: 2677–2681)
机译：背景：B型利钠肽（BNP）是心力衰竭评估的既定标志物，但尚未阐明心房切换手术（ASO）后BNP的预后质量。方法和结果：在ASO后的89例患者（中位年龄为24岁;范围为15-35岁）中，对BNP进行了测量。在48个月的随访期间，我们重点研究了严重的心脏事件，这些事件定义为代偿失调，心脏猝死或需要进行心脏移植。功能性（FC）I / II级患者（中位数35 pg / ml;范围3–586 pg / ml）的BNP显着低于FC III / IV（中位数246 pg / ml; 6名患者）中的BNP。范围14–1,150 pg / ml，P≤0.073）。芥末后的BNP明显高于Senning程序后的PNP（P≤0.030）。简单或复杂的大动脉（TGA）换位之间的BNP没有显着差异（P≤0.44）。 11名受试者（13％，95％CI：7–22％）在48个月内发生了严重的心脏事件。在ROC分析中，BNP对于有或没有严重事件的患者的辨别具有很高的预测价值（ROC曲线下的面积为0.90; 95％CI：0.76至> 0.99，P <0.001）。临界值为85 pg / ml（灵敏度为88％;特异性为85％）。另外，Senning后估计的无事件生存期比芥末手术后更长（P≤0.017）。简单或复杂的TGA患者在关键事件发生方面的结局无显着差异。结论：BNP是ASO后严重心脏事件的敏感且特异性的预后标志物。 （Circ J 2015; 79：2677–2681）

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